Mobile Mental Health Crisis Intervention in the Western Health Region of Newfoundland and Labrador

The impetus for this research is Recommendation #15 of the 2003 Luther Inquiry into the deaths of Norman Reid and Darryl Power: “IT IS FURTHER RECOMMENDED that the Regional Health Boards establish mobile health units to respond to mentally ill persons in crisis where no criminal offence is alleged. Each unit would be developed locally and based on local needs.” Our stakeholder partners in the Western Regional Health Authority asked us to identify a range of mobile crisis intervention service models, some of which may be better suited to lower-density, rural populations and some of which may be better suited to higher-density areas like Corner Brook. Our partners expressed a particular interest in models that can be implemented with minimal additional human resources, but that involve local, face-to-face contact rather than telephone, electronic, or clinic-based models of service delivery. The term “crisis intervention” generally refers to any immediate, short-term therapeutic interventions or assistance provided to an individual or group of individuals who are in acute psychological distress or crisis. The term encompasses a number of after-the-fact interventions – such as rape counseling and critical incident stress debriefing – that would not be relevant to the kinds of situations described in the Luther Report. Given the project parameters specified by our partners at Western Health, we formulated a research question and a literature search strategy that would enable us to focus specifically on forms of crisis intervention that are designed to manage potentially dangerous mental health crises on-site rather than to mediate their impacts after the fact. Our research question is as follows: “What models of mobile– i.e., face-to-face – crisis intervention have proven effective in managing potentially violent mental health crises occurring outside the hospital setting?

SBMLToolbox: an SBML toolbox for MATLAB users

We present SBMLToolbox, a toolbox that facilitates importing and exporting models represented in the Systems Biology Markup Language (SBML) in and out of the MATLAB environment and provides functionality that enables an experienced user of either SBML or MATLAB to combine the computing power of MATLAB with the portability and exchangeability of an SBML model. SBMLToolbox supports all levels and versions of SBML

LibSBML: an API library for SBML

LibSBML is an application programming interface library for reading, writing, manipulating and validating content expressed in the Systems Biology Markup Language (SBML) format. It is written in ISO C and C++, provides language bindings for Common Lisp, Java, Python, Perl, MATLAB and Octave, and includes many features that facilitate adoption and use of both SBML and the library. Developers can embed libSBML in their applications, saving themselves the work of implementing their own SBML parsing, manipulation and validation software

Lumières d’un homme de l’ombre

C’est au TNP, auprès de Patrice Chéreau et de Roger Planchon, puis avec André Engel, qu’André Diot a fait de l’éclairage un art véritable, une discipline à part entière. D'abord cameraman puis chef opérateur de cinéma, collaborateur entre autres de Michel Deville, André Diot est l'un des initiateurs de la profession d'éclairagiste au théâtre. Il a contribué à en officialiser le statut, à développer son métier techniquement et artistiquement en apportant son savoir-faire des plateaux de cinéma..

L’Histoire terrible mais inachevée de Norodom Sihanouk, roi du Cambodge, de la Cartoucherie au pays des Khmers

En 2010, Ariane Mnouchkine missionne Delphine Cottu et Georges Bigot pour remettre en scène L’Histoire terrible mais inachevée de Norodom Sihanouk, roi du Cambodge d’Hélène Cixous avec les acteurs cambodgiens de Phare Ponleu Selpak. En 1984, au retour d’un séjour qu’elles effectuent dans un camp de réfugiés cambodgiens à la frontière thaïlandaise, Ariane Mnouchkine et Hélène Cixous décident de mettre en scène un des drames les plus effroyables de l’histoire contemporaine. Une épopée de près d..

Emergency department triage and COVID-19: Performance of the Interagency Integrated Triage Tool during a pandemic surge in Papua New Guinea

Objective: To determine the sensitivity of the Interagency Integrated Triage Tool to identify severe and critical illness among adult patients with COVID-19. Methods: A retrospective observational study conducted at Port Moresby General Hospital ED during a three-month Delta surge. Results: Among 387 eligible patients with COVID-19, 63 were diagnosed with severe or critical illness. Forty-seven were allocated a high acuity triage category, equating to a sensitivity of 74.6% (95% CI 62.1–84.7) and a negative predictive value of 92.7% (95% CI 88.4–95.8). Conclusion: In a resource-constrained context, the tool demonstrated reasonable sensitivity to detect severe and critical COVID-19, comparable with its reported performance for other urgent conditions

Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemic

Background: Triage implementation in resource-limited emergency departments (EDs) has traditionally relied on intensive in-person training. This study sought to evaluate the impact of a novel digital-based learning strategy focused on the Interagency Integrated Triage Tool, a three-tier triage instrument recommended by the World Health Organization. Methods: A mixed methods study utilising pre-post intervention methods was conducted in two EDs in Papua New Guinea. The primary outcome was the mean change in knowledge before and after completion of a voluntary, multimodal training program, primarily delivered through a digital learning platform accessible via smartphone. Secondary outcomes included the change in confidence to perform selected clinical tasks, and acceptability of the learning methods. Findings: Among 136 eligible ED staff, 91 (66.9%) completed the digital learning program. The mean knowledge score on the post-training exam was 87.5% (SD 10.4), a mean increase of 12.9% (95% CI 10.7–15.1%, p < 0.0001) from the pre-training exam. There were statistically significant improvements in confidence for 13 of 15 clinical tasks, including undertaking a triage assessment and identifying an unwell patient. In an evaluation survey, 100% of 30 respondents agreed or strongly agreed the online learning platform was easy to access, use and navigate, and that the digital teaching methods were appropriate for their learning needs. In qualitative feedback, respondents reported that limited internet access and a lack of dedicated training time were barriers to participation. Interpretation: The use of digital learning to support triage implementation in resource-limited EDs is feasible and effective when accompanied by in-person mentoring. Adequate internet access is an essential pre-requisite

No sex scandals please, we're French: French attitudes towards politicians' public and private conduct

The notion of distinct ‘public’ and ‘private’ spheres underpins much normative and practical engagement with political misconduct. What is less clear is whether citizens draw distinctions between misdemeanours in the ‘public’ and ‘private’ spheres, and whether they judge these in systematically different ways. This paper explores attitudes to political misconduct in France. French citizens are often said to be particularly relaxed about politicians’ private affairs, but there has been little empirical evidence for this proposition. Drawing on original survey data, this paper demonstrates clearly that French citizens draw a sharp distinction between politicians’ public and private transgressions, and are more tolerant of the latter